Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 3008624 | KY |
NPI | 1003236712 |
---|---|
Provider Name | Brianna D Cornett |
First Address | Cumberland, KY 40823-0320 |
Second Address | Cumberland, KY 40823-1714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2014 |
Last Update Date | 12/05/2021 |